Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 10122752 | FL |
NPI | 1013586528 |
---|---|
Provider Name | Stephany Hernandez |
First Address | Doral, FL 33178-3860 |
Second Address | Miami, FL 33125-3355 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2021 |
Last Update Date | 18/06/2021 |